Water intake keeps type 2 diabetes away? Focus on copeptin
In both diabetic subjects and animal models high levels of vasopressin (AVP) have beendetected. The relationship between AVP and glucose metabolism is mediated through several direct andindirect effects and most of them are still unknown.
We have reviewed 100 manuscripts retrieved from Cochrane Library, Embase and Pubmeddatabases in order to highlight a possible relationship between copeptin and type 2 diabetes and to provideinsights on the molecular mechanism that could explain this association.
Results and conclusions
AVP potentiates CRH action at pituitary level resulting in an increased ACTH secretion and in turn in an increased cortisol secretion that escapes the negative feedback loop. Further, AVP regulates insulin and glucagon secretion through V1b receptor and promotes hepatic glycogenolysis and gluconeogenesis through V1a receptor. In addition to worsen glucose metabolism, AVP has been reported to have a role in the pathogenesis of diabetic complications such as cardiovascular diseases, kidney and ocular complications. Due to the very low concentration of AVP in the blood, the small size and poor stability, the assay of AVP is very difficult to perform. Thus, copeptin, the stable C-terminal portion of the prepro-vasopressin peptide has been identified as an easier assay to be measured and that mirrors AVP activity. Although there are promising evidence that copeptin could be involved in the pathogenesis of type 2 diabetes, further studies need to demonstrate the importance of copeptin as clinical marker to predict glucose metabolism derangements.
KeywordsCopeptin Type 2 diabetes Water Vasopressin Insulin resistance Insulin secretion
Prevention of renal and vascular end-stage disease
Coronary artery disease
Serum and glucocorticoid inducible kinase 1
Sodium glucose transporter 1
G.M. wrote the manuscript, L.G., G.A., M.V., and F.O. helped to draft the manuscript, C.D.S. and A.C. reviewed the manuscript, and S.S. conceived the manuscript
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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